Manejo conductual anticipatorio en paciente Síndrome X Frágil: Reporte de caso

Abstract

Introduction: Fragile X syndrome (FXS) is an inherited X-linked disorder that usually affects males and mainly causes intellectual disability. It is the most frequent cause of hereditary intellectual disability after Down Syndrome. Objective, to describe behavioral management based on anticipatory techniques. Case report: Informed consent form was signed. A male patient, age 7 years 4 months, presented with FXS chronic asthma, surgically corrected cleft palate, sensory and tactile hypersensitivity, behavior classified as 2 according to Frankl with no social risk. The patient was in the first phase of mixed dentition, with high cariogenic risk, generalized gingival inflammation, hypo mineralization and deficient ionomer glass restoration in 65, with mobility. Panoramic radiograph revealed agenesis of 25 and rotation of 24. Previous history of dental treatment performed only under general anesthesia. Adaptation was based on the use of anticipatory material: pictograms on dental visit, dental examination, radiographic examination, and presentation videos. Patient allowed panoramic examination, intraoral examination, prophylaxis and complex restorations. There are multiple options for the adaptation of dental treatment for FXS patients, chosen considering the patient's behavior and preferences. FXS patients present sensory integration problems, so individualized therapy is required, adjusting to the patient's strengths and weaknesses, achieving improved functioning that will have an impact on their quality of life. Conclusion: In FXS patients, behavioral strategies should be developed to establish effective communication. Adaptation techniques should be in accordance with the patient's needs, allowing a better performance and quality of life for him and his family.